Objective To study the clinical efficacy of modified Liuwei Dihuang Decoction (LDD) combined with metformin plus atorvastatin for the treatment of type 2 diabetes mellitus (T2DM) complicated with hyperlipidemia. Methods A total of 120 cases of T2DM patients complicated with hyperlipidemia were randomly divided into study group (N=60) and control group (N=60), which were treated with LDD combined with metformin plus atorvastatin orally, and with oral use of metformin plus atorvastatin respectively. The course of treatment lasted for 12 weeks. Before and after treatment, we compared the blood levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose(2hPG), glycosylated hemoglobin(HbA1C), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), and low-density lipoprotein cholesterol(LDL-C) in the two groups. After treatment, we evaluated the therapeutic effect of the two groups. Results (1) The total effective rate of the study group was 95.0％, and that of the control group was 83.3％, the effective rate of the study group being significantly higher than that of the control group (P < 0.05). (2) After treatment, the blood levels of FBG, 2hPG and HbA1C of both groups were significantly lower than pre-treatment levels (P <0.001), and the levels of FBG, 2hPG and HbA1C of the study group were significantly lower than those of the control group (P<0.05, P<0.01 or P<0.001). (3) After treatment, the TC, TG and LDL-C levels of both groups were significantly lower and HDL-C was higher than pre-treatment levels (P < 0.001); the levels of TC and TG levels of the study group were significantly lower and HDL-C was higher than those of the control group (P < 0.05 or P < 0.001). Conclusion LDD combined with metformin plus atorvastatin exerts certain effect for the treatment of T2DM complicated with hyperlipidemia, and is more effective than metformin or atorvastatin alone.

Objective To explore the relationship between pituitary tumor transforming gene(PTIG) and Ki67 expression and their significance in multiple adolescent breast fibroadenomas (fibroadenomatosis)and single persons(fibroadenomas) and their clinical value.Methods A total of 53 fibroadenomatosis and 160 fibroadenomas specimens in our hospital were collected.All the samples were fixed with 10％ formalin and then embedded with paraffin.The protein expression of PTTG and Ki67 was detected by immunohistochemical staining.The relation between expression of PTTG and Ki67 in fibroadenomatosis was analyzed.Results The positive rate of PTTG and Ki67 was higher in fibroadenomatosis than in fibroadenomas (P ＜ 0.005).Conclusions High expression of PTTG and Ki67 in fibroadenomatosis leads to the proliferation of tumor cell and upregulates tumor angiogenesis.High expression of PTTG and Ki67 may play important roles in tumorigenesis and pathological process of fibroadenomatosis.

OBJECTIVE To investigate drug-resistance status of Klebsiella pneumoniae(KPN) in nosocomial infections and provide the reference for rational application of antibiotics.METHODS According to Nationwide Rules of Clincal Laboratory Manipulation,the strains were identified and drug-sensitivity test was performed by K-B methods.The extended-spectrum-?-lactamases(ESBLs) producing strains were detected by double-disc synergy test and disc confirmed test.RESULTS Totally 356 strains of KPN were mainly isolated from respiratory department,gerontology department,neurosurgery department and chest surgery department.The specimens were mostly sputum,pharynx swab,urine and secretion.The detection rate of ESBLs-producing KPN was 36.0%.The drug-resistance rate to common antibiotics in ESBLs producers was generally higher than that in ESBLs nonproducers.No KPN was resistant to imipenem and meropenem.CONCLUSIONS Drug-resistance status of K.pneumoniae in nosocomial infections is very serious.We should strengthen monitoring and controlling of it.

[ ABSTRACT] AIM:To investigate the effect of edaravone ( ED) on the expression of caspase-3 and caspase-12 in the juvenile rat hippocampus after status convulsion ( SC) .METHODS: Juvenile male Sprague-Dawley rats were ran-domly divided into normal saline ( NS) control group, SC group and ED treatment group.The rats in each group were fur-ther divided into 5 subgroups according to different time points.The rats in SC group were kindled into epilepsy by lithium-pilocarpine chemical method.The protein expression of caspase-3 and caspase-12 was determined by immunohistochemistry methods.The mRNA expression of caspase-3 and caspase-12 was detected by RT-PCR.RESULTS:(1) The IA value of caspase-3 positive cells in 24~72 h SC group increased compared with NS group.With ED intervention, the IA value of caspase-3 positive cells decreased as compared with 48~72 h SC group.The results of RT-PCR showed that the mRNA ex-pression of caspase-3 was similar to the changes of protein.( 2 ) The results of immunohistochemistry showed that the IA value of caspase-12 positive cells in 12~72 h SC group increased compared with NS group.With ED intervention, the IA value of caspase-12 positive cells decreased as compared with 24~72 h SC group.The results of RT-PCR showed that the mRNA expression of caspase-12 was similar to the changes of protein.( 3 ) In ED group, Ⅴ grade convulsion was lower than that in SC group, and the latent period of seizures in ED group was significantly longer than that in SC group.CON-CLUSION:Edaravone inhibits the expression of caspase-3 and caspase-12 in pilocarpine-induced seizures in rat hippo-campus, suggesting that edaravone has protective effect against the damage caused by status convulsion.

Objective　 To improve the recognization and the diagnostic accuracy of brachial cleft cyst (BCC) by CT scan. Methods 　CT findings of 10 BCC proved surgically and pathologically were retrospectively reviewed. Results　 BCC，CT number 22～33 Hu；with the enhanced wall and the non-enhanced cystic part. If infections exist，the margin would be obscure and the internal density be increased. These cysts commonly located in the anterior triangle area of the neck or along the anterior border of the sternocleidomastoid muscle. The first brachial cleft fistula was not displayed. Conclusion　 CT scan can not only clearly show the location，enhanced characters and the relationship to the adjacent tissues of the BCC，but also can be possible to make the diagnosis of the BCC，but not the brachial cleft fistula.

Objective To investigate effects of mini-invasive treatment for patients with vascular malformations in oral and maxillofacial region . Methods 8 cases with vascular malformations in oral and maxillofacial deep or special region were injected pingyangmycin into vein lake by color ultrasound-guided needle aspiration. Results All cases were cured and no facial nerve was damaged. Follow-up ranged from 6 months to 1 year, and no recurrence was found. The vascular malformations of 4 cases in maxillofacial deep region were disappeared or instead of fiber tissue with MRI detection 6 months after treatment. Conclusions Injecting pingyangmycin by color ultrasound guided-needle aspiration for patients with vascular malformations in oral and maxillofacial deep or special region is effective, safe and mini-invasive treatment.

OBJECTIVE To investigate the distribution and drug-resistance of Pseudomonas aeruginosa(PAE) in nosocomial infections to provide the scientific evidence for the clinical use of the antibiotics.METHODS PAE was cultured and identified according to the National Rules of Procedures Clinical Laboratory.Drug resistance was analyzed by K-B methods.RESULTS A total of 318 strains of PAE were mainly isolated from intensive care unit(ICU),departments of cerebral surgery and chest surgery.Drug-resistance of PAE to 14 kinds of antibiotics showed that SXT(91.2%),cefotaxime(89.9%),aztreonam(70.1%),gentamicin and ciprofloxacin(69.8%),respectively.And the resistance to piperacillin,levofloxacin and cefepime was 50.0%.CONCLUSIONS Drug-resistance status of P.aeruginosa is very serious.Hospital should strengthen monitoring and controlling of it.

Objective To explore a venipuncture method that can reduce the pain, improve the suc-cess rate of puncture as well as reduce vascular injury. Methods Self-controlled method was applied in 200 patients, needle tips with 20～25°,31～40°,41～50°, 51～60°, > 60° angles on the top of the blood ves-sels,the inclined plane of the needle parallel to the longitudinal axis of the blood vessel (that was,the in-clined plane to the left or right) or traditional method with upward of needle tips were adopted, the observa-tion group and the control group were divided according to different methods, pain and success rate of puncture were compared. Results There were differences between the two groups,results of the observa-tion group were better than those of the control group (except when > 60°, success rate showed no differ-ence). Conclusions Venipuncture with needle tip parallel to the longitudinal axis of the blood vessels can significantly reduce pain in patients, improve the success rate of puncture and reduce the vascular in-jury, which were superior to the traditional venipuncture method. Whatever method is chosen, 51～60° is the best angie into the vessel.

Object To investigate the effects of ultra-fine powder technique and granularity of pellets on dissolution rate in vitro. Methods The dissolution rate of ultra-fine ERMIAO PILL with different granule diameters in vitro was measured and compared with the index of berberine by UV spectro-photometry. Results The dissolution parameters T 50 and T d of four kinds of ultra-fine ERMIAO PILL are 61.60, 19.48, 17.84, 8.97 min and 102.3, 33.29, 26.98, 14.77 min, respectively. Those of general powder ERMIAO PILL with granule diameter of 2.4 mm are 89.61 and 155.68 min. Conclusion The dissolution rate of ultra-fine powder is quicker than that of general powder, and the rate increases with the granularity of PILL decreasing.

Objective To determine whether it is necessary to execute pre-labor pubic shaving.Methods Women(336 cases)who received pubic shaving through vaginal delivery from 2003 to 2006 were set as the control group.Women(103 cases)who were waiting for delivery currently in our hospital were set as the test group.The test group only received perineal cleaning without pubic shaving.If episiotomy was needed during the operation,the perineal hair Was cut by scissors.The perineum infectious rate and postpartal infection Was compared in the two groups.We interviewed the patients attitude for pubic shaving and counted the numing time used for pubic shaving.Results The perineal infection in the test group was 5.8%,which was no statistically different from that of the control group(2.4%),U=0.33,P＞0.05.Totally 95% women in the test group support this method demonstrated humanization.In the telephone folow-up visit for patients in the control group they comphined itch and discomfort during the regeneration of pubes.The average numing time for pubic shaving Was(4.6±0.6)minutes.Conclusions No pubic shaving for pre-labor skin preparation was feasible.If operation was disturbed by pubes we could use scissors to cut it short.This method could reduce the skin infection and propagation of blood-derived infectious disease.It increased the comfort of parturient,saved time and proved to be a nursing method of humanization.